Mass. Medical Home Initiative Launched

Massachusetts is moving to the head of the pack in terms of service delivery realignment with the release on July 9th of the Patient Centered Medical Home (PCMH) RFR.    As many as 50 practice sites could be selected to participate in a model that includes enhanced payments for care coordination and care management and shared savings to be calculated based on experiences of a control group of practices.

The PCMH demonstration, which will be three years in length, involves both MassHealth and several commercial insurers; although according to HHS Secretary Judy Ann Bigby,  it is far more “Medicaid centric” than had been envisioned in earlier development stages.

With tremendous focus on each PCMH influencing what happens to the patient when she/he is not in the physicians office, the PCMH offers partnership opportunities for home health agencies. The RFR states that although  all PCMH practice sites must provide care coordination for high risk patients, these services can be handled through a contractual relationship – as long as it clearly reflects a team approach.  Additionally, with the shared savings component, practices will have a real financial stake in keeping patients out of hospitals and ERs.

Since small physician practices still dominate the  market in Massachusetts, the states hopes to see a good representation of these in the mix of selected PCMHs.  Home health agencies should be prepared to discuss this new opportunity with physician offices and to offer support and services to assist in their applications.

The full RFR is to be found on the state’s competitive bidding site Comm-Pass (search for (1LCEHSMEDICALHOMES).  General information about the project, including some dates and times of informational webinars to be held next week, can be found on the EOHHS medical Home page

Author: Pat Kelleher

Pat Kelleher is Executive Director of the Home Care Alliance of Massachusetts.

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